Are Students Being Misdiagnosed?

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Providing an education to students with trauma is a delicate balancing act, and I often find myself wondering if I am on the winning or loosing side of supporting this group of students. When I first heard the words trauma informed care, I wasn’t sure exactly what it was, especially compared to the strategies I was already utilizing at the school I work in. I knew the students came with histories that were heartbreaking. I also quickly found that at times my staff and I struggled to find the best way to help a student whose traumatized body and mind were in desperate need of something other than a teacher telling them to sit still and complete another math problem.

So many of the students I work with are on cocktails of medication, but yet it isn’t always solving the problem. Recently an article published in 2014 by Rebecca Ruiz came across my Facebook page. It talked about trauma and “How Childhood Trauma Could Be Mistaken for ADHD,” and I found myself wondering if this information could be the catalyst to changing how we approached our work with students in the classroom. Not just at my school, but other schools in the district as well.

Dr. Nicole Brown who was completing her residency at John Hopkins University found despite using medication to decrease student’s impulsive behavior, it was still difficult to get the student’s behavior under control.  I quickly realized this as something that should be looked at, and strategies implemented to support students in the classroom – using trauma informed care strategies might be what was needed to help a student to feel safe enough to take a deep breath and begin to heal.

Students who have been exposed to trauma have a heightened fight or flight response. The symptoms of dissociation and seeming not to care about school can, in fact, be a student’s inability to process and work through the trauma that they have faced in their lives.  Dr. Brown discussed that some may think the prevalence of ADHD is rapidly increasing, however ADHD may not be increasing but the number of traumatic events and trauma students are facing has risen dramatically. If students are living in poverty, have been exposed to abuse, or are currently living in an unsafe home, how do they come to school and focus on arithmetic or writing a paper?

ADHD symptoms and students with trauma often look similar – an inability to sit still, lack of focus, and students struggling to complete or start a task. Students can be impulsive and struggle to really think through a situation in order to come to a resolution. In the classroom the student may talk out of turn, move constantly and struggle to get their ideas out. So, how do you know if this is ADHD or Trauma? There is an ACE study where you can determine what your students trauma score is. If they have 2 or more adverse childhood experiences, it might be best to look at this student through this lens to determine which types of programming and supports would benefit them the most.

After reading this article, I wanted to know, how do I address or help this group of students? “Conquering the Impossible Task,” by Susan Collins on Stories from School AZ blog, described how 1 out of 8 children have an anxiety disorder. Which is also related to stress, trauma and the pressures of the world around us. She recommends that teachers can help students by building them up. If a student is in class attempting to do work, but is unfocused, we can change the conversation to be something like, “I know you like to sometimes stand when you are learning, and that you do a great job of sharing your ideas, would you like to stand over here with me and tell me your ideas first.” This allows a teacher to build off the student’s skill strengths instead of focusing on what they are not doing.

From the research I conducted, I also found that decreasing a student’s fight or flight response helps. If a student becomes angry when they are asked to complete an assignment, working towards finding a safe way for the student to ask for help can decrease the students immediate response to simply flee from the situation and instead face it because they begin to trust they are safe.

We should focus on the relationship. It is critically important for students with trauma to have a safe adult.  This is not going to happen overnight. It takes time for students to rebuild trust when they have been let down by other people. It isn’t the big gesture. It is sometimes the small ones that make the most amount of difference with a student. Get your counselor or social worker involved. Even if the student does not have minutes, having someone to bounce ideas off of on how to implement trauma informed supports for a student in the classroom could help provide support for you and for the student.

Dr. Austine Etcheverry

I started my educational career as a 1:1 paraprofessional for a student who was blind and had a cognitive impairment. After this amazing opportunity, I decided teaching was my passion. In 2007 I became a certified special education teacher and taught 5th – 8th grade resource. Throughout my career in education, I have held various leadership roles such as a technology coach, an exceptional needs coach and an IEP coordinator. Three years ago, I decided to begin pursuing my National Board Certification and was fortunate enough to achieve in December 2018. I currently have the privilege of being the principal in the Avondale Elementary School District at a school for students with an emotional disability. I have my own social media company where I write and create dental blogs. I have also had the honor of publishing articles in a dental magazine as well as published a young adult science fiction series. In December 2018, I became a certified yoga instructor and recently completed my Doctorate in Education Leadership and Administration from Aspen University.